In February 2022, the Court of Protection was faced with the question of whether a kidney transplant was in the best interests of William Verden. The case highlighted the legal, ethical and clinical complexities of treating potential kidney transplant patients with impaired decision-making. Above all, it exposed the potential risk of discrimination on the basis of disability when treatment decisions in relation to potential kidney recipients with impaired capacity are being made. In this paper, we draw on the Verden case (...) to (1) examine the role of the Court of Protection in cases relating to patients with impaired decision-making capacity who require a transplant, (2) to highlight the lack of empirical data on patients who have faced inequitable access to transplant and (3) highlight the shortcomings of the existing legal and regulatory framework in England and Wales guiding clinical decision making for patients in William’s position. We consequently argue that there is a clear need for action to ensure equitable access to transplant for those in William’s position. Furthermore, we suggest that there is a responsibility incumbent on policy makers and clinicians alike to develop a meaningful, and meaningfully operational, framework centred on preventing discrimination against potential organ recipients based on their decision-making capacity. (shrink)

Previous research demonstrates that implicitly learned probability information can guide visual attention. We examined whether the probability of an object changing can be implicitly learned and then used to improve change detection performance. In a series of six experiments, participants completed 120–130 training change detection trials. In four of the experiments the object that changed color was the same shape on every trial. Participants were not explicitly aware of this change probability manipulation and change detection performance was not improved for (...) the trained shape versus untrained shapes. In two of the experiments, the object that changed color was always in the same general location . Although participants were not explicitly aware of the change probability, implicit knowledge of it did improve change detection performance in the trained location. These results indicate that improved change detection performance through implicitly learned change probability occurs for location but not shape. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

CHAPTER ONK Negotiating Positions: The Politics of Virtue and Virtu [Virtu] rouses enmity toward order, toward the lies that are concealed in every order, ...

Stem cell biology and systems biology are two prominent new approaches to studying cell development. In stem cell biology, the predominant method is experimental manipulation of concrete cells and tissues. Systems biology, in contrast, emphasizes mathematical modeling of cellular systems. For scientists and philosophers interested in development, an important question arises: how should the two approaches relate? This essay proposes an answer, using the model of Waddington’s landscape to triangulate between stem cell and systems approaches. This simple abstract model represents (...) development as an undulating surface of hills and valleys. Originally constructed by C. H. Waddington to visually explicate an integrated theory of genetics, development and evolution, the landscape model can play an updated unificatory role. I examine this model’s structure, representational assumptions, and uses in all three contexts, and argue that explanations of cell development require both mathematical models and concrete experiments. On this view, the two approaches are interdependent, with mathematical models playing a crucial but circumscribed role in explanations of cell development. (shrink)

Book reviewed in this article: Life Before Birth: The Moral and Legal Status of Embryos and Fetuses. By Bonnie Steinbock.

Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in (...) this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England. (shrink)

Examining stem cell biology from a philosophy of science perspective, this book clarifies the field's central concept, the stem cell, as well as its aims, methods, models, explanations and evidential challenges. The first chapters discuss what stem cells are, how experiments identify them, and why these two issues cannot be completely separated. The basic concepts, methods and structure of the field are set out, as well as key limitations and challenges. The second part of the book shows how rigorous explanations (...) emerge from stem cell experiments, and compares these to other kinds of scientific explanation. Model organisms, the role of genes, and the significance of collaboration are also discussed. The last part of the book considers relations to systems biology and clinical medicine, arguing that both the mathematical models of the former, and ethical principles of the latter, are necessary for stem cell biology to deliver on its promises. (shrink)

Feminist Interpretations of Hannah Arendt, edited by Bonnie Honig, a collection of critical feminist essays on Hannah Arendt, illustrates both the disorientation and the insights that can result when feminist philosophers come to terms with a canonical figure who is a woman.

Is it wrong to bring children who will have serious diseases and disabilities into the world? In particular, is it unfair to them? The notion that existence itself can be an injury is the basis for a recent new tort known as "wrongful life" (Steinbock, 1986). This paper considers Feinberg's theory of harm as the basis for a claim of wrongful life, and concludes that rarely can the stringent conditions imposed by his analysis be met. Another basis for maintaining that (...) it is morally wrong to have children under extremely adverse conditions is suggested: a principle of parental responsibility. We also argue that having children under such conditions may be unfair to the children, even if they have not been (in Feinberg's sense) harmed. Finally, we consider when conditions are sufficiently awful that having children might be viewed as incompatible with being a good parent and unfair to the child. (shrink)

This article argues that the meaning of the word ‘autism’ experienced a radical shift in the early 1960s in Britain which was contemporaneous with a growth in epidemiological and statistical studies in child psychiatry. The first part of the article explores how ‘autism’ was used as a category to describe hallucinations and unconscious fantasy life in infants through the work of significant child psychologists and psychoanalysts such as Jean Piaget, Lauretta Bender, Leo Kanner and Elwyn James Anthony. Theories of autism (...) were then associated both with schizophrenia in adults and with psychoanalytic styles of reasoning. The closure of institutions for ‘mental defectives’ and the growth in speech therapy services in the 1960s and 1970s encouraged new models for understanding autism in infants and children. The second half of the article explores how researchers such as Victor Lotter and Michael Rutter used the category of autism to reconceptualize psychological development in infants and children via epidemiological studies. These historical changes have influenced the form and function of later research into autism and related conditions. (shrink)

This paper examines Honig’s use of Rancière in her book ‘Democracy and the Foreigner’. In seeking to clarify the benefits of ‘foreignness’ for democratic politics it raises the concern that Honig does not acknowledge the ways in which her own democratic cosmopolitanism may be more akin to Rancière’s police than politics. By challenging Honig’s assertion that democracy is usually read as a romance with the suggestion that it is more commonly read as a horror, I unpick the interstices of Honig’s (...) and Rancière’s work to separate foreignness from democratic cosmopolitanism. Instead, although I posit democratic cosmopolitanism’s potential as a police more conducive to politics I also suggest that the particular salience of Honig’s ‘foreigner’ figure is that it supplements Rancièrian politics, demonstrating a praxis of ‘looking anew’ at our ordinary social practices. By making these seem strange to us, we can discover a new critical perspective from which to question and subvert, thereby furthering the potential of Rancièrian democratic politics. (shrink)

Ontologies of living things are increasingly grounded on the concepts and practices of current life science. Biological development is a process, undergone by living things, which begins with a single cell and (in an important class of cases) ends with formation of a multicellular organism. The process of development is thus prima facie central for ideas about biological individuality and organismality. However, recent accounts of these concepts do not engage developmental biology. This paper aims to fill the gap, proposing the (...) lineage view of stem cells as an ontological framework for conceptualizing organismal development. This account is grounded on experimental practices of stem cell research, with emphasis on new techniques for generating biological organization in vitro. On the lineage view, a stem cell is the starting point of a cell lineage with a specific organismal source, time-interval of existence, and ‘tree topology’ of branch-points linking the stem to developmental termini. The concept of ‘enkapsis’ accommodates the cell-organism relation within the lineage view; this hierarchical notion is further explicated by considering the methods and results of stem cell experiments. Results of this examination include a (partial) characterization of stem cells’ developmental versatility, and the context-dependence of developmental processes involving stem cells. (shrink)

If there is collective scientific knowledge, then at least some scientific groups have beliefs over and above the personal beliefs of their members. Gilbert's plural-subjects theory makes precise the notion of ‘over and above’ here. Some philosophers have used plural-subjects theory to argue that philosophical, historical and sociological studies of science should take account of collective beliefs of scientific groups. Their claims rest on the premise that our best explanations of scientific change include these collective beliefs. I argue that Gilbert's (...) account of collective scientific belief does not provide a better explanation of scientific change than a non-collective alternative. A different defence of collective scientific belief and knowledge is needed. (shrink)

In this paper, we assume that organ donation policy in the United States will continue to be based on an opt-in model, requiring express consent to donate, and that families will continue to have the prerogative to make donation decisions whenever the deceased person has not recorded his or her own preferences in advance. The limited question addressed here is what should be done when a potential donor dies unexpectedly, without any recorded expression of his or her wishes at hand, (...) while a family decision is being sought. (shrink)

This paper examines a case of failed interdisciplinary collaboration, between experimental stem cell research and theoretical systems biology. Recently, two groups of theoretical biologists have proposed dynamical systems models as a basis for understanding stem cells and their distinctive capacities. Experimental stem cell biologists, whose work focuses on manipulation of concrete cells, tissues and organisms, have largely ignored these proposals. I argue that ‘failure to communicate’ in this case is rooted in divergent views of explanation: the theoretically-inclined modelers are committed (...) to a version of the covering-law view, while experimental stem cell biologists aim at mechanistic explanations. I propose a way to reconcile these two explanatory approaches to cell development, and discuss the significance of this result for interdisciplinary collaboration in systems biology and beyond. (shrink)

"This book presents a theoretical discussion of problems and issues encountered in the Native American community from a perspective that accepts Native knowledge as legitimate. Native American cosmology and metaphor are used extensively in order to deal with specific problems such as alcoholism, suicide, family, and community problems. The authors discuss what it means to present material from the perspective of a people who have legitimate ways of knowing and conceptualizing reality and show that it is imperative to understand intergenerational (...) trauma and internalized oppression in order to understand the issues facing Native Americans today."--pub. website. (shrink)

In summary, the creation and maintenance of the Wistar Rats as standardized animals can be attributed to the breeding work of Helen Dean King, coupled with the management and husbandry methods of Milton Greenman and Louise Duhring, and with supporting documentation provided by Henry Donaldson. The widespread use of the Wistar Rats, however, is a function of the ingenuity of Milton Greenman who saw in them a way for a small institution to provide service to science. Greenman's rhetoric, as captured (...) in his Director's Reports, prepared annually from 1905 until his death in 1937, shows that he was unusually sensitive to his times and to the economics of science and of society. In the era when biology was being defined, he recognized in the rat the potential to be a living analog to the pure chemicals that legitimated experimental science. From management literature he extracted the ideals of uniformity of product, standards of quality, and efficiency of production, applying them to scientific practice to generate an animal model that thrives as standard equipment in laboratories throughout the world today.I will close with a quote from Frederick W. Taylor that is a cogent statement of the contribution to science and scientific progress made by standardized tools and their creators. Equating the surgeon and the workman, Taylor wrote: [He is given] the finest implements, each one of which has been the subject of special study and development ... [and] the very best knowledge of his predecessors; and, provided with standard implements and methods which represent the best knowledge of the world up to date, he is able to use his own originality and ingenuity to make real additions to the world's knowledge, instead of reinventing things which are old.Standardized tools, whether surgeons' implements or laboratory-bred rats, are one of the vehicles for carrying scientific knowledge forward from generation to generation. In this sense, Greenman's Wistar Rats have done their job, in his words, of “providing service to science.”. (shrink)

The prelims comprise: Introduction Better Alternative Than Abortion? The Morality of Prenatal Diagnosis Prenatal Genetic Testing as Prevention The Line‐drawing Question Conclusion Note.

This review surveys three central issues in philosophy of stem cell biology: the nature of stem cells, stem cell experiments, and explanations of stem cell capacities. First, I argue that the fundamental question ‘what is a stem cell?’ has no single substantive answer. Instead, the core idea is explicated via an abstract model, which accounts for many features of stem cell experiments. The second part of this essay examines several of these features: uncertainty, model organisms, and manipulability. The results shed (...) light on the form of our emerging knowledge of stem cells: mechanistic explanations. The third part of the essay sketches some key features of these explanations, which are constructed by a collaborative experimenting community. (shrink)

Stem cells are defined as having capacities for both self-renewal and differentiation. Many different entities satisfy this working definition. I show that this general stem cell concept is relative to a cell lineage, temporal duration, and characters of interest. Experiments specify values for these variables. So claims about stem cells must be understood in terms of experimental methods used to identify them. Furthermore, the stem cell concept imposes evidential constraints on interpretation of experimental results. From these constraints, it follows that (...) claims about stem cell capacities are inherently uncertain. This result has important implications for stem cell research. (shrink)

In light of the recent emergence of predictive techniques in law enforcement to forecast crimes before they occur, this paper examines the temporal operation of power exercised by predictive policing algorithms. I argue that predictive policing exercises power through a paranoid style that constitutes a form of temporal governmentality. Temporality is especially pertinent to understanding what is ethically at stake in predictive policing as it is continuous with a historical racialized practice of organizing, managing, controlling, and stealing time. After first (...) clarifying the concept of temporal governmentality, I apply this lens to Chicago Police Department’s Strategic Subject List. This predictive algorithm operates, I argue, through a paranoid logic that aims to preempt future possibilities of crime on the basis of a criminal past codified in historical crime data. (shrink)

Schematic conflict occurs when evidence is interpreted in different ways (for example, by different people, who have learned to approach the given evidence with different schemata). Such conflicts are resolved either by weighting some schemata more heavily than others, or by finding common-ground inferences for several schemata, or by a combination of these two processes. Belief functions, interpreted as representations of evidence strength, provide a natural model for weighting schemata, and can be utilized in several distinct ways to compute common-ground (...) inferences. In two examples, different computations seem to be required for reasonable common-ground inference. In the first, competing scientific theories produce distinct, logically independent inferences based on the same data. In this example, the simple product of the competing belief functions is a plausible evaluation of common ground. In the second example (sensitivity analysis), the conflict is among alternative statistical assumptions. Here, a product of belief functions will not do, but the upper envelope of normalized likelihood functions provides a reasonable definition of common ground. Different inference contexts thus seem to require different methods of conflict resolution. A class of such methods is described, and one characteristic property of this class is proved. (shrink)

Many explanations in molecular biology, neuroscience, and other fields of experimental biology describe mechanisms underlying phenomena of interest. These mechanistic explanations account for higher-level phenomena in terms of causally active parts and their spatiotemporal organization. What makes such a mechanistic description explanatory? The best-developed answer, Craver's causal-mechanical account, has several weaknesses. It does not fully explicate the target of explanation, interlevel relation, or interactive nonmodular character of many biological mechanisms as we understand them. An alternative account of MEx, emphasizing interdependence (...) among a mechanism's components, remedies these difficulties. (shrink)

:Empirical work has shown that patients and physicians have markedly divergent understandings of treatability statements in the context of serious illness. Patients often understand treatability statements as conveying good news for prognosis and quality of life. In contrast, physicians often do not intend treatability statements to convey improvement in prognosis or quality of life, but merely that a treatment is available. Similarly, patients often understand treatability statements as conveying encouragement to hope and pursue further treatment, though this may not be (...) intended by physicians. This radical divergence in understandings may lead to severe miscommunication. This paper seeks to better understand this divergence through linguistic theory—in particular, H.P. Grice’s notion of conversational implicature. This theoretical approach reveals three levels of meaning of treatability statements: the literal meaning, the physician’s intended meaning, and the patient’s received meaning. The divergence between the physician’s intended meaning and the patient’s received meaning can be understood to arise from the lack of shared experience between physicians and patients, and the differing assumptions that each party makes about conversations. This divergence in meaning raises new and largely unidentified challenges to informed consent and shared decision making in the context of serious illness, which indicates a need for further empirical research in this area. (shrink)